Learning or blaming? Understanding Nursing Students’ Barriers to Reporting Medication Errors: A Qualitative Study

Background: While the 'Just Culture' approach promotes reporting medical errors as a learning opportunity rather than punishment, studies indicate a gap between recognizing the importance of reporting and actual implementation. This study examined the barriers and facilitators to error reporting among nursing students. Methods: Using a descriptive-naturalistic approach nursing students who had reported experiencing a medication error or near-error during their clinical placements were interviewed and the data analysis was conducted using a thematic approach. Results: All participants experienced errors or near-errors, mostly during medication preparation and administration. Fears of negative impacts on grades or professional reputation, and concern about negative responses from instructors or peers, led some students to downplay events or avoid reporting. When instructors were empathetic, the atmosphere supportive, and dialogue encouraged, students were more likely to report incidents and view reporting as a means of professional growth and ethical responsibility. Conclusion: Nursing students report that errors are common. Avoiding reporting often reflects tension between formal expectations and informal norms, emotional discomfort, and organizational culture, rather than lack of responsibility. Future strategies should simplify reporting procedures, provide timely feedback, train instructors to foster empathy, and create safe spaces for discussing mistakes to strengthen a culture of reporting.